We want to hear your views on changes we are proposing to our guidance for registered pharmacies on providing pharmacy services at a distance, including on the internet.
Online pharmacy services can offer significant benefits for patients and the public, but there are also additional risks that need to be managed, to make sure medicines and other pharmacy services are provided safely to patients and the public.
We are planning to strengthen the safeguards that online pharmacies are expected to put in place for patients and the public, to make sure people only receive medicines that are safe and appropriate for them.
Have your say
We are seeking feedback on some key changes we want to make to the guidance. Please share your views via our survey by 9 October 2024.
Read the updated guidance in Welsh
About our proposals
We have reviewed our current guidance and identified some changes we want to make to further improve patient safety. As part of the review, we have considered the insights we have from enforcement action and fitness to practise cases relating to online pharmacies.
We have identified that there are greater risks to patient safety when online questionnaires are the only mode of consultation used, and when the information provided by the patient isn’t verified by the prescriber.
We have summarised the main changes we are proposing to make to the guidance below:
- Strengthening safeguards for people using online services:
We are proposing to include additional safeguards to those already in place in the guidance, to help strengthen the protection for patients and the public using online pharmacies.
The guidance outlines some medicines that are known to be associated with greater risks, so should not be supplied unless extra safeguards have been put in place to make sure they are clinically appropriate for the patient.
Due to their risk of misuse, we are proposing to add medicines used for weight management and to achieve weight loss, to the list of examples of medicines that should not be supplied unless extra safeguards have been put in place to make sure they are clinically appropriate, and are not suitable to be prescribed using a questionnaire model alone. This is in response to concerns raised with us relating to inappropriate supplies of weight-loss medicines that are resulting in risks and harm to patients.
We are also proposing to add to this list:
- medicines which have a high risk of fatality or serious harm to a patient if taken in overdose
- medicines where there needs to be a physical examination of the person to support a safe prescribing decision
- medicines labelled with a black triangle (▼ or ▼*)
We have also provided further guidance for prescribers to follow in circumstances where the person does not have a regular prescriber such as a GP, or if the person has not given consent to the prescriber to share information with the person’s GP. This emphasises that medicines should only be prescribed in exceptional circumstances in these cases, after verifying information provided by the patient.
- Selecting the appropriate mode of consultation:
We are proposing to include more guidance for pharmacy owners and superintendent pharmacists about what they need to consider when deciding on the appropriate mode of consultation to use for different services or medicines, to deliver safe and effective care.
This emphasises that there should be a means to allow two-way communication between the prescriber and the person when needed, and that some medicines are not suitable to be prescribed using an online questionnaire alone.
We are also providing further guidance for the prescriber on what they should do to verify the information that is provided to them by the person for some medicines, through a phone call, video consultation, or by contacting the person’s GP. We give an example of the importance of independently verifying a person’s weight, height and/or body mass index when prescribing medicines being used for weight loss. This will help to safeguard vulnerable people who may misuse the medication.
- Superintendent pharmacists and pharmacy owners both responsible for meeting the guidance
Currently, it is the responsibility of the pharmacy owner to meet the guidance. We are proposing that the Superintendent Pharmacist (where there is one) would also be responsible for meeting the guidance. - Being able to select a preferred prescription medicine during a consultation:
The current version of the guidance states that pharmacy owners should make sure that their website and the websites of companies they work with are arranged so that a person cannot choose a prescription-only medicine before there has been an appropriate consultation with a prescriber. We are proposing to update this to say that the pharmacy website and the websites of associated companies should be arranged so that a person has an appropriate consultation with a prescriber before any supply of a prescription-only medicine is made.
The website could allow people to indicate their preferred choice of medicine, for example a preferred brand or formulation, before the consultation. However, it should be made clear that the decisions about treatment are for both the prescriber and the person to consider together during the consultation.
We are proposing this change in response to feedback from pharmacy owners and members of the public highlighting the benefits of allowing a person to indicate their preferred choice of medicine during the consultation.
We can safely make this change to the guidance as we are strengthening the guidance on the mode of consultation, prescriber accountability and shared decision-making, to make sure people only receive medicines that are safe and appropriate for them.
Get involved
We are seeking views on the updated guidance until 9 October 2024 and want to hear views from everyone with an interest in online pharmacy, including members of the public, carers, pharmacists, pharmacy technicians and other health professionals, and pharmacy owners